Histologic Review of Cidofovir-Treated Recurrent Respiratory Papillomatosis

Abstract

This is the first report of pathologically evaluated recurrent respiratory papillomatosis specimens taken before and after treatment with intralesional cidofovir. No dysplasia was identified, and there were no significant dysplastic changes in the specimens analyzed.

Exophytic sinonasal papillomas and nasal florid papillomatosis: A retrospective study

“…Cidofovir is a potentially effective adjuvant therapy to prevent recurrence. We considered using Cidofovir in our patient with frequent recurrence despite repeated surgery but decided against it due to the absence of data in a nasal setting, its nephrotoxicity, and because some doubt reigns about its role in the malignant transformation of laryngeal papillomatosis . Overall, its use is currently limited in this setting.…”

Degrees of dysplasia and the use of cidofovir in patients with recurrent respiratory papillomatosis

“…Indeed, the natural rate of dysplasia within RRP reported in the literature is highly variable. In a histologic review of 96 biopsy specimens of RRP, Lindsay et al in 2008 reported no cases of dysplasia with increased nucleus to cytoplasm ratio in 8.4% with no associated mitoses 13. In comparison to this series, in a study by Preuss et al, 19.7% of the adult onset single RRP patients (n = 61), 12.1% of the adult onset multiple RRP patients (n = 74), and 7.5% of the juvenile onset multiple RRP patients (n = 53) had mild to moderate dysplasia, with a carcinoma in situ rate of about 4% to 5% in each of those groups 2…”

Minimizing surgical management through the use of adjuvant medical therapies

“…Subsequently, several studies alleviated heightened concerns regarding cidofovir. A study published by Lindsay et al showed no evidence of an increased risk of malignant transformation with the administration of cidofovir in patients with papillomatosis 2. An extensive review of adverse effects authored by Broekema and Dikkers showed 2.7% of cases of dysplasia when using cidofovir 3.…”